The Affordable Care Act plan are required to provide ten essential benefits. It is helpful to know when you are searching for one of these plans, you are guaranteed these benefits:
- Ambulatory patient services: Outpatient care you get without being admitted to a hospital.
- Emergency services: Basically, this is a trip to the emergency room where you truly need care as soon as possible. This also means that you won’t be penalized if the hospital is out of network.
- Hospitalization: Treatment you receive in the hospital as part of inpatient care. Plans may limit coverage for extended stay, such as surgery and overnight stays.
- Pregnancy, maternity, and newborn care: Services you receive both before and shortly after giving birth.
- Mental health and substance use disorder services: This includes behavioral health treatment, counseling and psychotherapy.
- Prescription drugs: This includes approved prescription drugs that have been categorized by the government. One from each category must be covered.
- Rehabilitative and habilitative services and devices: This includes services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills.
- Laboratory services: This includes diagnostic tests and some preventive screenings.
- Preventive and wellness services and chronic disease management: This includes services to prevent disease and increase wellness in the population. Services such as diet counseling, colorectal cancer screening, Type 2 diabetes screenings, and immunization vaccines.
- Pediatric services: This includes oral and vision care, vaccines, immunizations, and well-child visits (Adult dental and vision coverage aren’t essential health benefits).
If one of these categories is essential to you or a person in your family, it’s worth it to take a look at an Affordable Care Act plan!
